AEGiS-14IAC: Pregnancy outcomes and follow-up among HIV-infected drug users.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Pregnancy outcomes and follow-up among HIV-infected drug users.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. MoOrE1071)

Coulon M, Rey D, Poizot-Martin I, Gallais H, Obadia Y
ORS Paca, Marseille, France

OBJECTIVES: To describe obstetrical history and factors that may have influenced pregnancy outcomes among the 137 women included in the MANIF 2000 cohort, a study that enrolled 467 patients HIV-infected through injecting drug use.

METHODS: A qualitative study based on semi-structured in-depth interviews carried on among the 19 women who have been pregnant since they have been aware of their HIV status.

RESULTS: The 19 women declared 43 pregnancies: 12 had elective abortions (19 events), 2 had ectopic pregnancies, 2 had spontaneous abortions and 15 delivered (20 events).18/19 women were HCV co-infected. 14/19 elective abortions occurred before 1996 and the large diffusion of zidovudine prophylaxis. Abortion decision was more often related to young age, drug use or lack of stable partnership (12 cases) than to HIV status of the women (7 cases). 14/20 deliveries occurred after 1996. 13 pregnancies were planned and 7 occurred after an unprotected sexual intercourse. Decision to have a child was related to stable relationship and/or fair clinical and biological conditions regarding HIV-infection. All women were informed about HIV vertical transmission risk but none of them knew HCV vertical transmission risk. Follows-up were made by obstetricians and HIV specialists. 4 women were on maintenance treatment during pregnancy and 9 had HAART. One child was HIV-infected (1990) and 1 was HCV-infected (1997).

CONCLUSION: IDU pregnant women who have regular follow-up for their HIV-infection, do not care about medical advice when they have chosen abortion. When they have planned to have a child, they seek for specialised medical care, they have regular obstetrical follow-up and good compliance to therapy. In the context of pregnancies, the opportunity of information about HCV infection is relatively neglected in comparison with the large diffusion of information about HIV prevention and risk of vertical transmission.

Keywords: AEGIS, HIV Infections, Pregnancy Outcome, Disease Transmission, Vertical, HIV Seropositivity, Zidovudine, Acquired Immunodeficiency Syndrome, Delivery, Obstetric, Abortion, Induced, Abortion, Spontaneous, Counseling, Greece, Human, Female, Pregnancy, Child, transmission, surgery

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MoOrE1071